干扰素治疗慢性丙型肝炎发生甲状腺功能异常的分析

目的：探讨干扰素治疗慢性丙型肝炎患者后发生甲状腺功能异常的情况及相关因素的分析。方法回顾性分析206例慢性丙型肝炎患者，观察89例干扰素治疗前和117例治疗后甲状腺功能的异常情况及其影响因素，Logistic分析发生甲状腺功能异常的危险因素。结果干扰素治疗前的89例患者中，有23例合并甲状腺功能异常，其中甲状腺功能减退症7例，甲状腺功能亢进症2例，亚临床甲状腺功能减退症14例；干扰素治疗后的117例患者中，有17例发生甲状腺功能异常，其中甲状腺功能减退4例，为桥本甲状腺炎2例和非自身免疫性甲状腺功能减退2例；甲状腺功能亢进1例；亚临床甲状腺功能减退症12例。多元Logistic回归分析显示，女性（OR＝5．828）、体内预存抗甲状腺自身抗体（OR＝35．393）是慢性丙型肝炎患者使用干扰素治疗后诱发甲状腺疾病的独立危险因素。结论干扰素治疗慢性丙型肝炎可导致甲状腺功能异常的发生；对体内预存大量抗甲状腺过氧化物酶抗体的女性，要监测甲状腺功能，定期复查。

Analysis of thyroid diseases induced by interferon in patients with chronic hepatitis C

Objective To investigate and analyze related factors about the occurrence of thyroid diseases induced by interferon in treatment of chronic hepatitis C. Methods A retrospective analysis of 206 patients with chronic hepatitis C （117 interferon-treated patients and 89 non-interferon-treated patients）was performed. Risk factors of thyroid dysfunction were evaluated by logistic regression analysis. Results Among 89 patients without interferon therapy,23 had combined thyroid dysfunction：7 of hypothyroidism,2 of hyperthyroidism and 14 of subclinical hypothyroidism. Among 117 patients receiving interferon therapy,there were 1 7 cases suffering thyroid dysfunction,including 4 of hypothyroidism （2 cases of Hashimoto＆#39;s disease and 2 cases of non-autoimmune thyroid dysfunction）,1 of hyperthyroidism and 12 of subclinical hypothyroidism. Logistic regression analysis showed that the risk factors,which correlated independently with interferon-induced thyroid diseases in patients with chronic hepatitis C,were female （OR= 5 . 828 ）and pre-stored anti-thyroid peroxidase antibody （OR= 35.393）. Conclusion The rate of thyroid dysfunction in patients with chronic hepatitis C was 25.8% ,and the rate of thyroid dysfunction induced by interferon in patients with chronic hepatitis C was 14.5% . For patients with chronic hepatitis C virus treated with interferon,especially women whose pre-stored anti-thyroid peroxidase antibody is in a large number,related indexes of thyroid function should be monitored regularly to prevent thyroid diseases.